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COVID’s Mental Health Fallout Will Last a Long Time. Here’s How we’re Targeting Pandemic Depression and Anxiety

24/03/2021 by Marie

Source: Pexels

Richard Bryant, UNSW

Although Australia is now largely COVID-free, the repercussions of the pandemic are ongoing.

As the pandemic enters its second year, many people will be continuing to suffer with poor mental health, or facing new mental health challenges.

The effects of recurrent lockdowns, fears about the effectiveness of the vaccines, restricted movement within and beyond Australia, and the bleak economic outlook are taking their toll on psychological well-being.

Now is the time to think about sustainable, evidence-based mental health programs that will serve Australians as we confront the mental fallout of the pandemic in 2021 and beyond.

The evidence is in

We now have incontrovertible evidence mental health has deteriorated during the pandemic. Large studies that assessed people’s mental health before and during COVID-19 have reported marked increases in anxiety, depression and post-traumatic stress since the pandemic began.

Although many experts predicted people with pre-existing mental disorders would be most vulnerable, we’ve seen even greater increases in psychological distress among those without a history of mental illness.

Unemployment and financial stress have exacerbated psychological problems during the pandemic. The major concern is that the increase in mental health problems will persist for years because of the economic downturn facing most nations.

Importantly, suicide rates increase during economic downturns. One study showed each 1% increase in unemployment was associated with a 1% increase in suicides.

The impact of unemployment and financial hardship on mental health is relevant for many Australians, as fears of reduced support from the JobSeeker and JobKeeper schemes loom. Although the government this week announced the JobSeeker payment will go up, welfare groups have warned it’s still not enough.

So what can we do?

The question now facing many nations is how to manage the unprecedented number of people who may need mental health assistance. There are several challenges.

First, lockdowns, social isolation, and fear of infection impede the traditional form of receiving mental health care in clinics. These obstacles might now be greater in other countries with higher infection rates, but we’ve certainly seen these challenges in Australia over the past year.

Second, many people who have developed mental health conditions during the pandemic would never have had reason to seek help before, which can impede their motivation and ability to access care.

Third, many people experiencing distress will not have a clinical mental disorder, and in this sense, don’t require therapy. Instead, they need new skills to help them cope.

Since the pandemic began, there’s been widespread promotion of smartphone mental health apps as a remedy for our growing mental health problems.

While these programs often work well in controlled trials, in reality most people don’t download health apps, and even fewer continue using them. Further, most people who do use health apps are richer, younger, and often in very good health.

Evidence does suggest apps can play a role in delivering mental health programs, but they don’t represent the panacea to the current mental health crisis. We need to develop more effective programs that can be scaled up and delivered in an affordable manner.

One approach

Man experiencing COVID mental health fallout
Source: Pexels

A few years ago, the World Health Organization and the University of New South Wales (UNSW) jointly developed a mental health treatment program.

The program consisted of face-to-face group sessions teaching people affected by adversity new skills to manage stress more effectively. It has been shown to reduce anxiety and mood problems in multiple trials.

My team at UNSW has adapted this program during COVID-19 to specifically address the mental health needs of people affected by the pandemic. A clinical psychologist leads weekly sessions via video-conferencing over six weeks, with four participants in each group. The sessions cover skills to manage low mood, stress and worries resulting from the pandemic.

Typically, mental health programs have attempted to reduce negative mood and stress by using strategies that target problem areas. A newer approach, which we use in this program, focuses on boosting positive mood, and giving people strategies to optimally experience positive events and pleasure when faced with difficulties.

In controlled trials this strategy has effectively improved mental health outcomes, even more than a traditional program.

Trialling this tailored program around Australia in recent months, we’ve found it effectively improves mood and reduces stress. Although we haven’t yet published our results in a peer-reviewed journal, our preliminary data suggest the program results in a 20% greater reduction in depression than a control treatment (where we give participants resources with strategies to manage stress and mood).

This raises the possibility agencies could provide simple but effective programs like these to people anywhere in Australia. Delivering a program by video-conferencing means it can reach people in remote areas, and those not wishing to attend clinics.

One of the common patterns we’ve seen in previous disasters and pandemics is that once the immediate threat has passed, governments and agencies often neglect the longer-term mental health toll.

Now is the time to plan for the delivery of sustainable, evidence-based mental health programs.


Australians experiencing distress related to the pandemic can express interest in participating in the trial program here.

If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.

Richard Bryant, Professor & Director of Traumatic Stress Clinic, UNSW

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Are you feeling COVID’s mental health fallout? Sign up to my email newsletter for more tips and advice for reducing stress.

Filed Under: Finding Happiness & Resiliency Tagged With: COVID, mental health, stress, worry

The Good and the Bad of Stress (E33)

31/08/2020 by Marie

Happiness for Cynics

In this week’s episode, Marie and Pete discuss some studies on stress, uncovering that stress can be both good and bad, but it’s all in how you perceive it.

Transcript

M: You’re listening to the podcast Happiness for Cynics. I’m Marie Skelton, a writer and speaker on resilience and change.

P: And I am Peter Furness, a bringer of bingo, lover of lingo and a passer of Pinot Grigio.

M: Ew.

P: [Laugh] Yeah, ew… Each week we will bring to you the latest news and research in the world of positive psychology, otherwise known as happiness.

M: So if alcohol is no longer numbing your pain.

P: Or you want to laugh, love and live like a voracious beast.

M: Or you just want to know what all the fuss is about.

P: [Singing] Then this is the place to be.

M: Because this week we’re talking about…

P: Stress!

[Dun, Dun, Duunnnn!]

[Happy Intro Music]

M: Alright, we’re talking about stress, and in particular… and the reason we talk about stress is because it is the complete opposite of happiness, really.

P: Oh, is it?

M: Well, not the opposite. You’ve got all these negative things, and stress is one of them. And they really do impact your ability to be happy.

P: Yes, I’ll agree.

M: So that’s why we’re talking about happiness, ah we’re not talking about happiness-

P: Stress?

M: – we’re talking about stress. Yes, and there are two talks that have shaped my thinking for this episode. So, one of them is by Kell… One of them is by Kelly Mc. [Stumbling over words.]

P: [Laughter and clapping]

M: Damn it. This is just not happening. One of them is by Kelly McGonigal, and she’s a health psychologist, and her 2013 Ted Global Talk is called How to Make Stress Your Friend. And I highly recommend that one and the other one. And again, I just feel bad that I know I’m butchering these people’s name.

P: [Laugh.]

M: I don’t know any way around this.

P: Well unless you’re going to research linguistics. Then you’re just gonna, you know have a bash?

M: Yep. So, Madhumita Murgia is a journalist, editor and speaker with expertise in the fields of science, health and technology, and her 2015 Ted talk [How Stress Affects Your Brain] was all about how stress affects the brain. So..

P: Science, science, science.

M: Yes. Do you expect anything less from me Pete?

P: No definitely not.

M: So they’ve both got different ways of looking at stress in the brain and there’s two things I wanted to talk about. Madhumita talks about how stress isn’t always a bad thing. It could be handy for a burst of energy and focus like when you’re playing sport, there’s people cheering for you and it’s the final or when you’ve got a deadline looming at work and you’ve got to get this done right?

P: Yep.

M: And stress can be a real motivator. I don’t know if you’ve felt that.

P: It’s a lever. It’s a definite lever.

M: Yep.

P: It pushes you forward.

M: Absolutely. So stress can be a really good thing, right?

P: Mm Hmm.

M: Or have you ever had to speak in public? And you’re not quite comfortable speaking in public.

P: Yes.

M: Your capillaries open up, your heart beats faster and you just feel alive, right. So stress can be an amazingly good thing, right?

P: Yes.

M: But what Madhumita talks about is how, when it’s continuous, it actually begins to change your brain.

P: Ok, so our brain synapses and neurons change?

M: Yes. So if you are in a war zone, for instance, which is kind of the epitome of bad stress.

P: Well that’s the big end of it.

M: Right? Like, there is day to day first world, what you and I experience. And then there’s war. If you’re living in a war zone and you’re constantly worried about how to feed your family-  

P: How to survive.

M: – whether or not you’re going to live, whether or not you’ll be bombed with all of the horrible things that you and I can only guess at.

P: Yes.

M: That is a level of constant and deep stress, and that fundamentally changes the way your brain works. And there’s actually some really good research from a lot of the Holocaust survivors and people who lived through World War II.

P: I’m thinking World War II London straightaway, as soon as you said that.

M: About stress and how people react and how it changes the genetics and kids that were born from people who went through that level of stress. There is so much psychological, physiological and physical impact.

P: And change of behaviour, fundamental patterns that come about because you’ve lived through that experience.

M: Absolutely. There’s a great one that I’m thinking of from a physical point of view where people were starving, they were there, honestly, starving. They couldn’t get access to food. They were eating cardboard to just put something in their stomach and their children, children who are born around that time they were born with changes in their genes and make up that meant that they held onto any nutrient and any carbon and fat. And so they’ve all got obesity problems, so their parents were starving, and these people cannot lose weight. They cannot, because their bodies have been taught to hold on to everything.

P: Absolutely everything.

M: Yeah, and again the mind does the same sort of thing. So stress can be such a positive thing in short bursts, but when you experience it over a long period of time it can have the opposite effect.

P: Does it matter about the level of stress in terms of the perception of intensity? So you’re talking about the war zones and so forth, but are we talking about the day to day stuff.

M: Well, look I picked wars as an example, but the research and Madhumita is talking about what you and I experience as day to day stress.

P: So, first worlders?

M: Yeah, like commutes and crappy bosses, making rent and all of those day to day [stresses], making sure that you answer all the e-mails in your inbox in a time that is deemed socially acceptable. And all of that stuff is day to day pressure, and a lot of people have talked about burnout. And The World Health Organisation has definitely labeled that as a concern in the 21st century. But that level of stress is also having a negative impact on people’s brain.

P: Mm. OK. How much do we control that? How much can we take control of that interpretation of stress? Because I know where you’re heading with this. [Laugh]

M: I love that question, Pete. Why thank you.

P: [Laugh]

M: It’s like we discussed this episode beforehand.

[Laughter]

M: So, Kelly McGonigal, the person who was talking about beginning the episode she has done a whole bunch of research into how we need to start seeing stress as a good thing.

P: Exactly.

M: So she talks about a study which tracked 30,000 adults, that is a huge study. So when you normally talk about studies, there’s 100, 200, 500 maybe 1000 people that you’re looking at.

P: Yep, most study groups.

M: 30,000 adults in the United States, and they followed them for 8 years.

P: Wow.

M: Huge, huge study. And they started by asking people how much stress have you experienced in the last year? They also asked, do you believe that stress is harmful for your health? And then they use public death records to find out who died.

P: Oh, Wow.

M: Right? Let’s cut to the chase. If stress is going to impact your heart health your everything, your brain it’s going to change you at a fundamental level and lead to poor outcomes, we’re talking death here, right?

P: Yep.

M: Okay. And what they found was people who experience a lot of stress in the previous year had a 43% increased risk of dying. But, here’s the but.

P: [Laugh]

M: That was only true for the people who also believed that stress is harmful for your health.

P: So stress can be beneficial?

M: Only if you believe it is.

P: It’s about our perception.

M: Absolutely. This is the key!

P: [Laugh]

M: Now, obviously, we’re talking about a sample of 30,000 US people in a normal period.

P: Yes.

M: Now, I still, there’s no science to back this up, but I still believe that war is a whole other, you know kettle of fish.

P: It is. But..

M: There’s so much for us to learn. We’re not in war time in Australia here, and America isn’t either. There’s no more happening in America, so in a lot of first world countries where this research would apply, well you could say that it should apply, the way that you perceive stress will have an impact on whether or not it is negative.

P: Absolutely.

M: Or positive.

P: Absolutely, couldn’t agree more.

M: Yep.

P: And it’s really funny that I came across this through the teachings of the Dalai Lama.

M: Oh, we’re back on this again.

[Laughter]

M: Tell me more.

P: This is a Buddhist doctrine. It’s this capacity for human intelligence and to develop determination and use it in a positive way. It’s how we perceive our reactions to events. It’s not necessarily the event itself that is negative. It’s our perception of it, and if we can change the way that we react, we are reactionary beings and if we react in a certain way, that predicates stress and that predicates a whole series of biological and physiological changes.

M: Yes.

P: But if we change that perception, if we flip that switch and find some sort of way to create a positivity around it, see it as an opportunity to change, interpret it as a lever for intelligence, for education, then perhaps we can flip the switch on stress. Oh my God! That’s a, that’s a sound bite!

M: We can flip the switch on stress. OK, we’ll be quoting you on that.

P: Done.

M: Yes, I couldn’t agree more. There’s one thing even before I tripped over all this positive psychology stuff and when I truly was the cynic that we portray in all of our advertising, which I always believed the worry-ings of no one. If something was going to happen, it was going to happen.

P: Yes.

M: Stressing about it and worrying about it didn’t serve anyone.

P: I couldn’t agree more. Worry doesn’t serve anybody.

M: Don’t worry about breaking the egg. You deal with the broken egg, if it happens, right?

P: Yep. Or you take steps to prevent the egg from breaking.

M: Absolutely. But really, you just keep cooking.

P: [Laugh]

M: If it’s going to happen, it’s going to happen right?

P: Yep.

M: And that has always been something that I’ve believed in. I maybe had too much of a lazy air.. and see what happens.

P: Approach?

M: Yeah, and nearly dying kind of makes you reassess how carefree you have been.

P: Yeah, true. But in some ways that that blissful, I’m going to say ignorance, but you’re going to say arrogance in that respect, it gives you a certain ability to deal with things in different way. If you’re not in a highly stressed, reactionary state, something bad happens and you’re like ‘Okay, all right, let’s go with this. Let’s see where this leads.’ You can actually deal.

M: ‘I can cope with it.’

P: Yeah. ‘I can cope with it.’

M: ‘I can cope.’ So, I think again, like we’ve spoken about in the past, it’s about feeling the pain and feeling the negative emotions that comes with bad things happen. But then, knowing that it’s a temporary state.

P: And understanding there’s a path out of it, if you can find it. And there are certain things that happen where the path is not obvious and we’re talking grief. We’re talking the loss of a loved one. You know you’re going to stay in that for a little while. We’ve talked about that before in other episodes.

M: But there is an out, and that’s not if you can find it, it’s when, when it happens.

and you might need help.

P: Definitely, and that’s the case of human nature we are reactionary beings and we react in a certain way. If we can control that reaction or look at the different possibilities of that reaction. Then perhaps we can lessen the effects of stress.

M: Absolutely yep, absolutely. So to circle back to that study. So they found that people who experienced a lot of stress but did not view stress as harmful were no more likely to die. I really want to circle back to that the physical effects of how you perceive the world.

P: Oh the world.

M: How you perceive being victimised, being not able to cope, being passive. It’s like seeing yourself as a leaf in the wind versus in control and..

P: Being able to ride the wind?

M: Right. That perception fundamentally changes you physically to the point that you do or don’t die.

P: I could see why it would change the way that your brain works, how your synapses work the access of pathways of thought processes and so forth.

M: For a cynic, this is such a big leap.

P: Yeah, right.

M: Such a big leap.

P: What is it that stops you from being able to make that jump?

M: How I perceive the world is going to make me die, younger or not. [Psht.]

P: You just don’t believe it? Fundamentally don’t believe it?

M: Well, yeah.

P: Wow.

M: It’s all.. yes.

P: [Laugh] and then it isn’t.

M: It isn’t the science shows [it]. 30,000 people over eight years, that’s huge.

P: That’s a decent study.

M: That is a good study, that is, yeah, that passes.

P: It’s not anecdotal.

M: Yep, and it’s not so qualitative that three people were interviewed in depth, over 8 years.

P: And there were these differentiating factors.

M: Yeah, absolutely. So, the lowest risk of dying of anyone in this study, including people who had little stress, was people who believe stress is positive. So this is actually the next big thing. So stress is bad, is what we’re saying. If you think it’s bad.

P: Yep. If you can[‘t] flip that switch.

M: If you think stress is good, it has no impact on you whatsoever, even if it’s prolonged, repeated year after year, ongoing stress.

P: And I’m thinking of a personal story here of my lovely adopted Nan McSweeney, who was 103 when she died. Dear old Nan McSweeney, she –

M: – Tell me her secret!

P: [Laugh]

M: 103! My grandma’s 95 and I’m cheering for her.

P: Yeah?

M: Yep.

P: So Nan McSweeney. She was a very devout Catholic woman. Incredibly devout, she was actually the last known survivor to have personally met Mother Mary MacKillop in Australia. So she had this amazing faith and she clung to it, and she let that drive her life in many ways so that when stress did come up think bad things happened. This wasn’t a wealthy woman. [She] wasn’t a woman who had an easy life. She was a cattle farmer in Glenn Innes for most of her life. She would give it up to God. She would give it up to a higher power and have her trust that I’m meant to endure, whatever the challenge is but I know I can come out the other side of it and it was one of things that she gave to me. Now I, I was an anti-religious person when I was young, 21 year old in college and having every Sunday dinner with Nan McSweeney.

M: You still are. Both of us. Both of us are. That’s the premise behind our book, Self-Care is Church for Non-Believers.

P: [Laugh]

M: You can buy it from October.

P: [Laugh] Available on iTunes!

M: No, not iTunes. Amazon. Available on Amazon.

P: [Laugh] Getting back to the point. She had this wonderful resilience of like, ‘oh well, on we go’ and that reminds me of the attitude of the blitz in London and why the English are so stoic and they still to this day, they believe that a cup of tea will solve every problem.

M: It does.

P: It does because there’s a certain –

M: If you believe then it does.

P: There’s a control. There’s an element of control there. ‘I’ll make a cup of tea, we’ll sit down and we’ll talk about it’ and everyone buys into that. Imagine you’ve had this massive argument with your husband and you’re ready to kill each other. The French don’t do it, they actually go through it with knives and pistols and things and then have sex afterwards but that’s all fine.

M: Oh, South Americans, that’s a whole different.

P: Oh, yeah, whole other thing. But the British they go ‘I’m going to make a pot of tea’, and it’s this weird, wonderful sort of ‘I can control the tea’ and we’re going to sit down and we’ll have tea and through the tea we’ll find a solution because we’ll take that moment and there’s a belief in the process that I have control over one little element.

M: It’s all in how you perceive. And in a way, I think it’s kind of a shame that we’ve had such a good run.

P: Yeah, we’re victims of, victims of our own opulence.

M: Since WWII.

P: Yes.

M: Because we don’t have resilience. We don’t and we’re then tripping over normal, everyday life.

P: Influences.

M: People have injuries and disappointments and things that happened in their life that aren’t how they planned or wanted and we’re so not equipped for it.

P: Thrown by it.

M: So not equipped to deal with that, because where we’ve given this false sense of control over life nowadays.

P: Yes and then we go see them with their hands going ‘Oh, I can’t control anything!’

M: Yeah, absolutely. And there’s a few really good books, Homo Deus [by Yuval Noah Harari], and what is it? Guns… [Guns, Germs, and Steel: The Fates of Human Societies by Jared Diamond]. Anyway, [books] that show that there’s this false sense that we can control the randomness of life nowadays that we all have.

P: Yeah.

M: And so it really takes by surprise when it’s not actually something we can control.

P: But that’s the whole point and that’s what I go back to the ancient teachings are like it’s not about control.

M: Yes.

P: It’s about you have to give yourself over to these elements and go with them. But learn to find some control in the elements that you can. So you know a Buddhist monk would go to their meditation or a Catholic would go to their prayer. An English mum would go to her pot of tea. I cook.

M: And in the 21st century you would argue meditation and mindfulness have a place to combat stress when against too much?

P: Absolutely, Yeah, definitely.

M: Yeah, and I haven’t really bought into the meditation stuff.

P: We keep pushing this point.

M: Yeah, yeah. So maybe one day I’ll tip over the edge.

P: I’m going to sit you down and chain you up.

M: For me, it’s exercise.

P: Oh, yep.

M: I just need a good exercise, like a 30 minute run or a gym session and it re-centres me and I sleep well that night as a result. Like if I’m mentally stressed the physical exhortation balances me out.

P: That also comes down to a physiological [response], because it’s getting rid of your cortisol levels. It’s using up your adrenaline that’s in your body. It’s helping to dissipate those switched on elements and take you to a place of more calm. ‘OK, now I can switch off let go’, which is the essence of meditation.

M: Yep, what-evs. Right, we’re out of time.

P: [Laugh] Here we go with that one. We’ve got English tea parties.

[Laughter]

M: Okay, so stress is good but bad is the –

P: – it’s all about your perception. How you perceive stress is the key.

M: Look, I think that a lot of this again I’m going to summarise a lot of what we’ve talked about, we’re up to Episode 30 something or other and again what I keep learning from this fabulous science of positive psychology is that I have so much control.

P: Yes, we do have control.

M: We do have control.

P: We have the tools we need to wake up and use them.

M: Yep and sometimes you might want to burrow down and just let the emotion rule.

P: Yep, I agree.

M: But then again, you don’t have to always be in that place, right?

P: No.

M: You’ve got control over whether you choose –

P: Take action people.

M: – Choose happiness. I hate to say it cause it’s a T shirt slogan. But there’s so much behind that.

P: I agree.

M: Yeah.

P: That’s why we say it.

M: Yep. All right, So..

P: if you like this podcast, then please subscribe and like us on your favourite platform and remember that we have all our information on www.marieskelton.com. Org?

M: .com Pete obviously doesn’t go there ever…

P: It’s written in the website browser thingy that I click and goes ‘Yes, straight to’.

[Laughter]

P: Where we publish all our research and articles and links from our podcast episodes.

M: Thank you for joining us.

P: Choose Happiness.

[Happy Exit Music]

Related content: Read Moving On article How to Build Your Resilience With Mindfulness and Meditation, listen to our Podcast: The Power of Meditation (E9)

Filed Under: Podcast Tagged With: podcast, resilience, stress, worry

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